People who have survived a heart attack may want to reconsider taking painkillers known as NSAIDs, says a recent study published in the American Heart Association journal Circulation. According to the research, the commonly used painkillers may boost patients’ risk of second heart attack and death.

NSAIDs, for non-steroidal anti-inflammatory drugs, include prescription drugs such as Celebrex (celecoxib) as well as over-the-counter medicines like ibuprofen (Advil, Motrin) and naproxen (Aleve). Previous research has linked these pain relievers to a higher risk of heart-related death, but the current study suggests the risk may persist for at least five years.

Researchers from Copenhagen University Hospital Gentofte in Denmark identified nearly 100,000 heart attack survivors aged 30 or older who suffered their first heart attack between 1997 and 2009, and looked into whether or not they were prescribed NSAIDs afterward. Among the participants, 44% filled at least one NSAID prescription.

Those taking the drugs had a 59% higher risk of death from any cause one year after their heart attack and a 63% higher risk within five years afterward. Additionally, participants had a higher risk (30%) of having a second heart attack, or dying of heart disease, one year later. That risk was 41% higher after five years.

The finding is significant given that heart attack survivors’ elevated risk of second heart attack or heart-related death in the year after a first event typically tapers off within five to 10 years.

“The results support previous findings suggesting that NSAIDs have no apparent safe treatment window among heart attack patients, and show that coronary risk related to using the drugs remains high, regardless of the time that has passed since the heart attack,” said study author Dr. Anne-Marie Schjerning Olsen in a statement. “Allowing a drug to be sold without prescription must be perceived by the general public as a strong signal of safety, and may be contrary in this case.”

NSAIDs may increase heart attack risk by causing blood to clot more easily. These clots can block arteries and may encourage a heart attack. In 2007, the American Heart Association issued a warning about long-term use of NSAIDs, stating more research is needed on their heart safety.

Although the new study was observational and doesn’t prove that NSAID use causes second heart attacks or death, the authors conclude that their use should be reduced overall, and that regulators may want to reevaluate their over-the-counter availability.

After a heart attack, patients are usually prescribed aspirin — also an NSAID — but the authors note that aspirin is good for the heart and that the new findings don’t apply to that drug.